Hilary – Panic and Health Anxiety (specific fear of MS)

Hilary was a member of No More Panic forum who tried CBT4Panic and had some success. I have lost our initial emails but she got in touch after some time to tell me that her Health Anxiety was causing her problems again. She had always had a fear of having MS which had become triggered again.

H

I’m really sorry to email you again and again. You’d think I’d be over my anxiety by now. I feel like such a failure and please honestly just ignore this if you’d have enough, because I would have. And you’ve already helped me more than anyone else ever has! Thank you for that! I’m just going through another relapse and I guess looking for some guidance again. I’m sure you’re really busy so please if you can’t reply, I really do understand – I’m not just saying that!

I have been anxiety free since last September and felt absolutely great! I got a hangover and everything came back symptom wise… it’s these bloody sensations. I swear if they didn’t happen and it was JUST psychological anxiety. Or a usual symptom like palpitations I could fathom what the heck my body is up to….

I have become convinced I have MS because of terrible health anxiety. All my ‘symptoms’ started 4.5 years ago. I get weird feelings of tingling/crawling/burning in the left side of my body. It can increase and decrease throughout the day. I’ve had these sensations on and off for the past 4.5 years. They last around 1-2 months sometimes. The problem is, my health anxiety symptoms fit MS so well I find it hard to believe it’s anxiety. They come and go, like MS does. And therefore everytime I manage to get rid of them, it’s undermined because I attribute it to ‘another MS attack subsiding’. I have seen too many Dr’s to count, I have seen a neurologist, I’ve had an MRI of my brain anxiety disorder a nerve conduction test – all came back fine. All bloodwork comes back fine. They all tell me the same thing – it’s anxiety.

Here’s why I struggle to believe this, and if you could offer me any reassurance and support I am forever grateful because this is ruining my life. Basically, I can’t usually pinpoint an episode of great stress that triggers the sensations to come back. I could be incredibly anxious and no symptoms appear, but then one day- boom – they come back out of the blue. Why don’t they always appear with anxiety? Why only sometimes? Why the same set of symptoms every time? Why do they mimic my greatest feared illness? Also why do they stick around?

This one bothers me the most. Because if they didn’t stick around and died down once the anxiety had, I’d be able to believe it was anxiety more. I don’t understand how they return with the same pattern and sometimes they don’t return. I try to accept they are here and that it’s OK.

But I end up googling my symptoms, sitting crying all day long and feeling so depressed. But the anxiety and depression wouldn’t be here if it wasn’t for the symptoms, so I then worry it’s the ‘illness’ that’s creating the anxiety and depression too. I need help and I’m falling apart. I have my son who’d now 8 months and I feel like a failure to him and my partner. I feel like I should have beaten this already. I don’t know what to do. I don’t understand.

Thank you again.

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R

Sorry for the late reply

The symptoms are returning when you have no anxiety because THAT ironically is your biggest fear!

so when you are under stress or feel anxious you don’t worry about strange sensations because you can attribute them to something

but when you are going along fine and you get a weird sensation – and even the TINIEST sensation can set you off and trigger HUGE sensations very very quickly – then you feel it MUST be something OTHER than anxiety because you weren’t feeling particularly stressed or anxious

This is TEXTBOOK – classic panic

If you read at the start of book 1 again you will see I say very specifically that the reason we PANIC is because the symptoms happen out of the blue and for no apparent reason – but if we had a reason (like we were escaping from a fire) then we wouldn’t worry at all

Can you see this – that your main fear that these sensations are happening when you aren’t feeling anxious IS your BIGGEST fear – so hey presto – it happens

trust me your brain has locked in this fear at a subconscious level so you won’t even know its there until the SLIGHTEST tingle sets it off

Then you wonder why the same set of symptoms every time

again this is obvious – because your next BIGGEST fear is that you will have the same set of symptoms – so hey presto again – thats what you get because you are totally sending out fear signals

If my biggest fear was that when my arm tingles it might mean I’m having a heart attack then of course there will be a LOT of even unconscious focus on that happening – so if I feel ANY fight or flight or worry that it might ‘come back’ then since its my mind that is setting off the body’s fight or flight – it is HIGHLY likely that I will worry about my arm and the more I focus on it the more likely it is my arm WILL feel weird

Someone I was helping once told me that they were worried they had something (it actually might have been MS) and I said I dont think you do because the most prominent symptom was that your scalp gets extremely itchy

and what do you think happened – yes – within minutes they reported that their scalp WAS getting very itchy – it was a great way to show them how easily their fear can manifest as a symptom even if its completely made up

So – trust me – it is NOT at all surprising that you get the same symptoms or that they arise when you DON’T feel particularly stressed or anxious

in fact that is all a very clear indication that its classic panic reaction to fight or flight – mixed with health anxiety

I’ll tell you what helped me most when I went through any health anxiety (that came often with my panic disorder)

I would sit in a chair – in a very deliberate upright position – not slouched over in a ‘why me’ position – and then I would take a deep breath – relax all over – and then I would very calmy say to myself..

“ok so I think I have cancer (or whatever it was that month) and it might kill me – ok – if that’s what will happen then that’s what will happen – I’ve been checked out so I have done what I am expected to do – but lets say it is what I think – what then – then I’ll maybe die – ok – as scary as that sounds – everyone dies – its part of life – and its not just old people that die – kids die – teenagers die – MILLIONS of people are dying right now – people DO die – I cant avoid that – can I even for one second relax into the fact that I and everyone else WILL die some day – sooner or later – wont make much difference really – 2 years, 5 years, 10 years, 20 years its still a VERY VERY short time – I mean it seems like yesterday I was 15 years old – time flies – so really what I am afraid of right now WILL happen not too far from now – to EVERYONE – so since that is a completely unavoidable part of life maybe I CAN be ok with it – let go towards it – even for a millionth of a second – what is it I’m so afraid of – the dying, being ill, suffering – what?? MILLIONS of people have suffered too – it happens and people go through it and some die and some recover and some do it well and some don’t – thats all there is to it – but I am suffering worrying about it every second of every day and its NOT even happening !! What is the point in that..

so then I would ALLOW myself to experience the fear of being ill or dying – it wasn’t easy but I tried my best to let go and be WILLING to feel the fear of illness or death – because most of my waking day was being spent TOTALLY running away from the fear and it WASN’T working! – all my day was spent avoiding, planning, worrying, fearing, hiding, trying to be safe or find out some answer that would tell me once and for all that it WASN’T happening – that I was OK – but even when I got reassurance it didnt help after one or two hours I was worried again

anyway – I urge you to think deeply about this approach – it takes some courage but it can turn things around – when you face a fear it very often loses its power

Just ALLOW yourself or be WILLING to experience whatever it is you DESPERATELY don’t want to even contemplate

You will NEVER EVER get enough reassurance to make this fear go away – so you may as well try facing it instead

Hope that helps

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H

Thank you so much! I can’t believe how much a logical explanation calms me down and brings me back from catastrophising everything.

Especially what you said about how I don’t worry when I get the symptoms when I have a clear stressor to put them too. And how when they come ‘out of the blue’ it freaks me out so much.

Thank you!

I’ve also been paying close attention to how I hold myself today. I’ve noticed that I’ve been tensing the upper half of my body and almost holding my breath and shallow breathing from my upper chest, I do it ALL the time without even realising. I keep catching myself doing it. And I’m sure this plays a massive role in my anxiety and anxiety symptoms. Because it makes sense that a constantly tensed muscle would produce weird sensations like burning, etc doesn’t it?

I feel much more hopeful today and I’ve been trying to catch my negative thoughts before they turn into negative feelings.

My main goal is to be more accepting of the feelings though, like you said. Because as much as I can ‘catch’ these thoughts, this leaves me a bit anxious and on a knifes edge – so to speak – as part of me feels like I’m trying to submerge and ignore the feelings.

It really makes sense what you said about embracing and almost having a ‘do what you want’ attitude to the sensations. I get waves where I feel very much like this, but then a sensation will come on again and it becomes harder to do this.

Stupid Google and its years of information is so readily available in my mind that it feels like an constant battle between ‘you’re going to die some day anyway, enjoy life NOW! don’t worry you are fine’ and ‘omg you are clearly ill and the Dr’s think it’s anxiety because you mentioned that, remember that person on Google who had the same experience as you!’

I’m trying to see the logic in Google and how ‘headache turns out to be headache’ will never get as many hits as ‘headache turns out to be brain tumour’. People on Google are only speaking about their own experience and they are NOT Dr’s. And just because say 4 people had my symptoms and it was MS – what about the 20 people (including you!) who are fine apart from anxiety.

It’s the waves of intense fear, depersonalisation, doubt, over thinking and dread that get to me the most. They come out of nowhere. What would you recommend for these waves of dread? Would you approach them in the same acceptance type way?

I feel like I’m finally getting somewhere but I’m not quite there yet, like these sensations still terrify me deep down. Do you think people with anxiety will always have to work at it to stop it getting too much? Do you think I’ll always get these sensations because I’ve spent almost 4.5 years obsessing over them?

Sometimes I think that all of this is trapped grief and PTSD for losing my mum so suddenly and awfully in 2010.

I hope that all makes sense… and sorry for rambling on!

And truly thank you thank you thank you!! I don’t know what I’d do if I didn’t have a logical explanation and knowing I have this email support. I am forever grateful that you always take the time to reply. Because when a Dr says ‘it’s anxiety’ to me like I’m an idiot it really doesn’t help. I’d much rather a detailed 5 minute explanation about the nervous system, adrenaline and stress! Maybe that’s a ridiculous expectation….!

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R

Hi

Glad you were able to see how you were following the panic process to the letter 🙂

and GREAT that you were able to worry less and observe how you are holding yourself – that is very helpful

we dont even realise what we are doing half the time – then we wonder how on earth we can feel anxiety 🙂

Yes – please do work more on the ‘so what – do your worse -kill me if thats what you want..’ approach

I have often seen peoples symptoms mysteriously vanish as soon as I tell them to try to make the symptoms WORSE – when they do that the body gets the signal that there must be no danger because you are willingly going toward the sensations – so the fight or flight is switched off

Its amazing

For feelings of dread find the section in the book about obsessional thoughts – its in the second workbook and also in the separate book about Obsessional Thinking

where I explain how to hold yourself as the observer – this is INCREDIBLY powerful

The gist is that if you can see that you dont LIKE the feelings of dread then a part of you ISN”T the dread because it obviously knows what ‘non dread’ is like because it wants that rather than the horrible feelings of dread

it’s almost like you were a viewer in a cinema – neutral – and the film was making you feel ‘dread’ – so much that you thought ‘dread’ was the full truth of who you are

but if you suddenly remember you are in a cinema and you look AWAY from the screen and take in your surroundings the dread will just be something on the screen – NOT ‘who you are’ – or even anything to do with you

You can do this anywhere at any time

when the dread (or whatever) comes in – LET IT BE AS IT IS – while you hold yourself as a neutral observer of it – just feel yourself as the observer – which is ok – neutral – and it is watching this ‘dread’ movie – you dont even need to get rid of it – once you realise it is not the fullness of who you are it will just float around and eventually disolve

I’ll write more about trapped emotion later

try out the observer mode

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H

Thank you for your reply. Yesterday I had a good day, but today I’m struggling again. The feeling like my hand doesn’t belong to myself came back and also I feel like my body is split in two and the left and right sides are disconnected and feel very weird. As you can imagine this makes me feel insane. I just feel so spaced out and disorientated. And then stupidly I googled and found someone with MS that has these sensations too.

I feel like an idiot for googling. I just don’t know whether these are common symptoms too??

My brain seems to have a split second panic when it sees another persons hand and it’s like it can’t work out if it’s mine or not.

I feel crazy 🙁

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R

The very first sensations that put me in complete panic were not being able to feel my arms or legs

I ran out into my garden and took off my shoes and socks to see if I could feel the ground

I became completely overwhelmed with panic and that lasted for 5 years

During that time I had a mass of symptoms – that mimicked so many illnesses – I even has a paralyzed foot that lasted for a year (I had to drag it around) so you can imagine the thoughts I was having with all this

yet here I am – and it ALL stopped when I REALLY REALLY REALLY understood an practiced the CBT principles

I also had that feeling that someone else’s limb or hand was mine or mine was someone else’s

That is textbook panic symptom – it’s a kind of sensory overwhelm where we feel so anxious our senses are VERY exaggerated so we experience our surroundings in an unusual way – but it always peaks then falls and goes back to kind of normal till we panic again

This really is all VERY VERY normal anxiety symptoms

You have to FORCE yourself and decide what you want to do – practice 100% or practice 60% and search for reassurance for 40%

your decision will determine the rate at which you will make progress

at the end of the day it is up to you

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H

Thanks for your help! It really does help to know other people are experiencing similar symptoms. I’m so mentally exhausted and feel like I just want to sleep forever.

I wish I could accept these are symptoms of stress and anxiety more so. It’s like my brain keeps going ‘oh but your gut is telling you…’ and there’s a war going on.

I’ll have a couple days where my symptoms lessen and I feel much better but then all the doubts will start creeping back in.

I’ve been doing deep breathing which really helps with my panic and depersonalisation. And when I get ‘phantom hand syndrome’ (haha) I’ve started almost laughing at it and just going ‘haha that’s weird’ in my mind – like you recommended to me one time. So that’s really helped with that one.

My tingling/burning back is pretty scary and just feeling generally spaced out.

I just can’t get rid of the ‘gut feeling’ it’s something bad. It’s so annoying and stupid. And consuming.

Then I had the worst conversation with a friend who is experiencing severe crippling pain, bladder control loss – like real serious problems. And she’s saying that she’s gotten told it’s anxiety and she’s like ‘oh but Dr’s just enjoy telling you that because it saves them money’ and ‘oh they always get the scans wrong’ and ‘you could have MS and not know about it’ – and it was literally the worst conversation I could have heard at that point in time! I couldn’t believe it.

I’ve also started yoga which I hope will help. I have another Dr’s appointment the start of March and I’m not sure really whether to go because they never normally help!

Sorry for the ramble.

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R

Your comment that you want to sleep a lot may be useful

I found certain symptoms hung around a lot and the only thing that helped was getting more sleep

I read a report from a UK university that said that the Spanish siesta is actually a better way

because our body temp drops twice a day (or something like that) at night before sleep but also once during the day indicating we need sleep

so they recommended that you get into bed – properly – clothes off – jammy’s on – under the blankets – curtains closed for around 40 minutes and no more or else you disturb the night sleep

doing this REALLY helped me

if you cant do it because of work or whatever then at least try to take a break where you can really relax as much as possible

with regards friends telling you things you dont want to hear – that’s just par for the course – and its only a problem because you have anxiety – if you didnt have anxiety people could say anything and it would go in one ear and out the other

You also say you ‘cant get rid of’ the gut feeling

can you see the problem?

you desperately want to ‘get rid of’ it

why – because you must still believe its true

so study more until you get more glimpses that its not true then ACT that way by NOT needing to ‘get rid of’ anything because its ok if its there or not – who cares if its not harmful

This then stops the fear signals to the body and sends out ‘all is well – who cares’ signals so the body has no need to give out fight or flight adrenaline

it s a big puzzle

ask yourself – have you REALLY done the work as indicated in the 3rd book – the EXPOSURE book

have you tried ‘Interoceptive Exposure’ exercises or any of the other planned exposure to your fears

have you been continuously filling in the worksheets – writing down thoughts – writing down alternative thoughts and so on and so on

or have you spent more of your time either on Google or trying to accept / let go / relax / only when the symptoms arise

how much have you willingly experimented with exaggerating the symptoms or NOT googling or creating exposures etc

I have a feeling that the answer will be ‘not enough’ ?

At some point you have to make a stand – just stop cowing down to the minds habitual chatter and say – enough – now I’m going to turn and face this – do your worst – if I have MS then so be it – then thats what will be and I’ll deal with that rather than spend my life running around terrified about ‘maybe’ having something

you need to stop running

turn

face the FEAR

study it

see it

and put in 100% practice – not 50% or even 99%

let go 100%

even if your brain thinks that is dangerous

Take a risk – chance it

TEST it

do it

and see what happens

be willing that the horrible feeling will be with you ALWAYS

give up trying to make it NOT be there

do the OPPOSITE of what you have been doing

be willing to drop dead right now

be willing to get ill and deteriorate

be willing to have continuous feelings of fear about all the above

practice going towards rather than away from the fear

let it be EXACTLY as it is

then get on with other stuff

and repeat

and repeat

and repeat

🙂

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R

Just thought I would share an interesting idea

I have used this for myself many times

You have an EXTREME fear that you have MS (or whatever the flavour of the month is)

Has it occurred to you people who have NOT got panic or health anxiety but who actually GET MS don’t have the fears you have in the way you have it

People who dont have panic or HA just get ‘bad news’ and at THAT moment they may have a lot of anxiety but pretty soon they just accept that they have whatever and they start to work with it as best they can – some good days some bad

What I am trying to say is that probably 99.999% of people who actully DO get MS will NEVER EVER EVER have the anxiety about it that you do – either before or after

Why?..

Because you have panic and HA – not MS..

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H

Thank you for your continuing help! I’m just about to sit down and go through the entire CBT course again. I feel ready to get going and not live in fear anymore!